Relationship Between Adverse Childhood Experience Survey Items and Psychiatric Disorders.
Authors: Cawthorpe D, Marriott B, Paget J, Moulai I, Cheung S Abstract CONTEXT: Developmental psychopathology theory suggests a relationship between early childhood adversity and mental disorder. OBJECTIVE: To examine the relationship between the specific items on the Adverse Childhood Experiences (ACE) survey and the International Classification of Diseases, Tenth Revision (ICD-10) categories of psychiatric diagnoses in a pediatric sample. DESIGN: The sample included patients enrolled in the Child and Adolescent Addiction Mental Health and Psychiatry Program with both a completed ACE survey and at least 1 ...
Source: The Permanente journal - October 10, 2018 Category: General Medicine Tags: Perm J Source Type: research

Universal Screening for Social Needs in a Primary Care Clinic: A Quality Improvement Approach Using the Your Current Life Situation Survey.
CONCLUSION: By using a frontline improvement approach, these investigators could answer questions and address concerns most important to local operational stakeholders when implementing screening for social needs. When practitioners conduct universal social needs screening and more fully understand social needs prevalence in a primary care clinic, resources can be tailored more effectively to accommodate patient needs. PMID: 30296397 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - October 10, 2018 Category: General Medicine Tags: Perm J Source Type: research

Using Neighborhood-Level Census Data to Predict Diabetes Progression in Patients with Laboratory-Defined Prediabetes.
CONCLUSION: Area-level socioeconomic and food assistance data predict the development of diabetes, even after adjusting for traditional individual demographic and clinical factors. Clinical interventions should take these factors into account, and health care systems should consider addressing social needs and community resources as a path to improving health outcomes. PMID: 30296398 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - October 10, 2018 Category: General Medicine Tags: Perm J Source Type: research

Inadequate Clinical Indications in Computed Tomography Chest and Abdomen/Pelvis Scans.
CONCLUSION: The percentage of complete clinical indications for both CT chest and abdomen/pelvis scans was much lower than 50%, suggesting that more emphasis should be placed on providing complete clinical indications. PMID: 30296399 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - October 10, 2018 Category: General Medicine Tags: Perm J Source Type: research

Lessons Learned from Implementation of the Food Insecurity Screening and Referral Program at Kaiser Permanente Colorado.
This article describes barriers encountered and lessons learned from implementation and expansion of the Kaiser Permanente Colorado's clinical food insecurity screening and referral program, which operates in collaboration with a statewide organization (Hunger Free Colorado) to manage clinic-to-community referrals. The immediate goals of clinical screening interventions described in this article are to identify households experiencing food insecurity, to connect them to sustainable (federal) and emergency (community-based) food resources, to alleviate food insecurity, and to improve dietary quality. Additional goals are to...
Source: The Permanente journal - October 10, 2018 Category: General Medicine Tags: Perm J Source Type: research

Vidian Nerve Schwannoma: A Rare Skull-Base Neoplasm Presenting with Ocular Manifestations: A Case Report and Literature Review.
DISCUSSION: A literature review showed that this is the second reported case of a vidian nerve schwannoma presenting with ocular symptoms and that endoscopic resections are becoming the standard of care. Practitioners should be aware that vidian nerve schwannomas can present as a skull-base mass with predominantly ocular symptoms, including vision loss, secondary to mass effect. Consideration should be given to this entity in the setting of typical radiographic and histopathologic characteristics. Endoscopic approaches to resection are safe and have low morbidity. PMID: 30285912 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - October 5, 2018 Category: General Medicine Tags: Perm J Source Type: research

Sex-Based Differences in Symptom Perception and Care-Seeking Behavior in Acute Stroke.
CONCLUSION: This study suggests that there are sex-based differences in symptom perception and care-seeking behavior in acute ischemic stroke. PMID: 30285913 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - October 5, 2018 Category: General Medicine Tags: Perm J Source Type: research

Perceptions and Experience of Patients, Staff, and Clinicians with Social Needs Assessment.
CONCLUSION: Our findings support the continuing assessment of social needs at KP and identify issues that require attention as it expands. Assessment should not outpace organizational capacity to connect members with resources. Careful attention to communications is required because members may be uncertain or concerned about the purpose of the assessment and the dissemination of sensitive information. Messaging should assure members about data use and dissemination and what they can expect after screening. PMID: 30285914 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - October 5, 2018 Category: General Medicine Tags: Perm J Source Type: research

"Do You Really Need This Appointment?"
"Do You Really Need This Appointment?" Perm J. 2018 Oct 01;22: Authors: Abramson S PMID: 30285915 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - October 5, 2018 Category: General Medicine Tags: Perm J Source Type: research

Effect of an Electronic Alert on Targeted HIV Testing Among High-Risk Populations.
Authors: Hechter RC, Bider-Canfield Z, Towner W Abstract CONTEXT: Screening for HIV infection in medical settings remains suboptimal. OBJECTIVE: To examine the real-world effectiveness of an electronic clinician alert on the same-day HIV testing rate and early diagnosis in high-risk populations. DESIGN: We identified Kaiser Permanente Southern California Health Plan members aged 14 years or older who received tests for sexually transmitted infections. MAIN OUTCOME MEASURES: Encounter-based same-day HIV testing rate, positive test result rate, and CD4+ cell count and HIV viral load at diagnosis. RESU...
Source: The Permanente journal - October 5, 2018 Category: General Medicine Tags: Perm J Source Type: research

Cognitive Behavioral Therapy with Heart Rate Variability Biofeedback for Adults with Persistent Noncombat-Related Posttraumatic Stress Disorder.
Authors: Criswell SR, Sherman R, Krippner S Abstract OBJECTIVE: To test the effectiveness of a mental health therapy designed to reduce noncombat-related persistent posttraumatic stress disorder (PTSD) symptoms in 30 adult outpatients with a diagnosis of PTSD. The individual treatment offered modules to address PTSD nightmare distress, dissociation, general core skills, alterations in arousal and reactivity, avoidance, intrusion, and negative alternations in cognitions and mood. The therapeutic approach centered on cognitive behavioral therapy and heart rate variability biofeedback. METHODS: The study had 2 com...
Source: The Permanente journal - October 5, 2018 Category: General Medicine Tags: Perm J Source Type: research

Dnr.
DNR. Perm J. 2018 Oct 01;22: Authors: Livaudais F PMID: 30285918 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - October 5, 2018 Category: General Medicine Tags: Perm J Source Type: research

The Best Year of Angela's Life.
Authors: Sundar KR Abstract Using a patient story, this narrative demonstrates why health care organizations, specifically primary care clinics, should strive to identify and to address social needs. This story demonstrates how Kaiser Permanente Washington, by using community resource specialists, has empowered primary care clinics to address social needs in a health care setting to improve patient care and experience. PMID: 30285919 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - October 5, 2018 Category: General Medicine Tags: Perm J Source Type: research

Different Harm and Mortality in Critically Ill Medical vs Surgical Patients: Retrospective Analysis of Variation in Adverse Events in Different Intensive Care Units.
Authors: Park KU, Eichenhorn M, Digiovine B, Ritz J, Jordan J, Rubinfeld I Abstract BACKGROUND: Institutional harm reduction campaigns are essential in improving safe practice in critical care. Our institution embarked on an aggressive project to measure harm. We hypothesized that critically ill surgical patients were at increased risk of harm compared with medical intensive care patients. METHODS: Three years of administrative data for patients with at least 1 Intensive Care Unit day at an urban tertiary care center were assembled. Data were accessed from the Henry Ford Health System No Harm Campaign in Detroi...
Source: The Permanente journal - October 5, 2018 Category: General Medicine Tags: Perm J Source Type: research

Management of Hypertension on the Labor and Delivery Unit: Delivering Care in the Era of Protocols and Algorithms.
CONCLUSION: Labetalol treatment was appropriately initiated in many cases; however, protocol adherence could greatly improve. Potential factors affecting protocol compliance include shift changes, communication issues, and conflicting protocols. Institutions should review protocol compliance to improve care. PMID: 30227906 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - September 21, 2018 Category: General Medicine Tags: Perm J Source Type: research

Developing Community-Based Primary Health Care for Complex and Vulnerable Populations in the Vancouver Coastal Health Region: HealthConnection Clinic.
CONCLUSION: The study demonstrates how the Building Blocks approach can be adapted to operationalize high-performing primary care standards in settings serving complex and vulnerable populations. PMID: 30227907 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - September 21, 2018 Category: General Medicine Tags: Perm J Source Type: research

Image Diagnosis: Dysphagia Lusoria-An Unusual Cause of Dysphagia Diagnosed with Endoscopic Ultrasound.
Authors: Mandavdhare HS, Sharma V, Gupta P PMID: 30227908 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - September 21, 2018 Category: General Medicine Tags: Perm J Source Type: research

Spotlight on Antidiabetic Agents with Cardiovascular or Renoprotective Benefits.
Authors: Madievsky R Abstract Type 2 diabetes mellitus often goes hand in hand with cardiovascular and renal comorbidities. Stroke, myocardial infarction, heart failure, and chronic kidney disease are high-risk complications of type 2 diabetes that contribute to morbidity and mortality. Recent clinical trials have uncovered evidence that certain antidiabetic agents may confer cardiovascular and/or renal benefits such as reduced cardiovascular and all-cause mortality and reduced need for renal replacement therapy. Two landmark trials in particular, EMPA-REG OUTCOME (Empagliflozin, Cardiovascular Outcomes, and Mortal...
Source: The Permanente journal - September 21, 2018 Category: General Medicine Tags: Perm J Source Type: research

Contraception after Abortion and Risk of Repeated Unintended Pregnancy among Health Plan Members.
CONCLUSION: In response to this study, KPNC now provides reimbursement for LARC in all outside abortion contracts, internalized more abortions in KPNC facilities, and strengthened clinical recommendations for immediate, effective postabortion contraception, especially LARC. PMID: 30227910 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - September 21, 2018 Category: General Medicine Tags: Perm J Source Type: research

My Siren.
Authors: Battaglia A PMID: 30227911 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - September 21, 2018 Category: General Medicine Tags: Perm J Source Type: research

Uses and Misuses of Patient- and Neighborhood-level Social Determinants of Health Data.
Authors: Gottlieb LM, Francis DE, Beck AF Abstract Health care leaders in the US are actively exploring strategies to identify and address patients' social and economic hardships as part of high-quality clinical care. The result has been a proliferation of screening tools and interventions related to patients' social determinants of health, but little guidance on effective strategies to implement them. Some of these tools rely on patient- or household-level screening data collected from patients during medical encounters. Other tools rely on data available at the neighborhood-level that can be used to characterize ...
Source: The Permanente journal - September 21, 2018 Category: General Medicine Tags: Perm J Source Type: research

To Pace or Not To Pace? A Narrative Review of VIP Syndrome.
Authors: Khoo CS PMID: 30227913 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - September 21, 2018 Category: General Medicine Tags: Perm J Source Type: research

Urate-Lowering Therapy in Moderate to Severe Chronic Kidney Disease.
Authors: Levy G, Shi JM, Cheetham TC, Rashid N Abstract CONTEXT: Hyperuricemia is an independent risk factor for progression of kidney disease. OBJECTIVE: To determine whether lowering serum uric acid level (sUA) to below 6 mg/dL (target) improves mild to moderate chronic kidney disease (CKD) and whether CKD stage influences the benefit of lowering sUA to target. DESIGN: Retrospective epidemiologic cohort study conducted over 8 years. Estimated glomerular filtration rate (eGFR) was required in the 6 months preceding the index date (defined as first occurrence of sUA
Source: The Permanente journal - September 13, 2018 Category: General Medicine Tags: Perm J Source Type: research

Clostridium Difficile-Associated Infection in Trauma Patients: Development of the Clostridium Difficile Influencing Factors (CDIF) Score.
Authors: Karamanos E, Gupta AH, Stanton CN, Mohamed A, Patton JH, Schmoekel N Abstract CONTEXT: Clostridium difficile-associated infection (CDAI) can result in longer hospitalization, increased morbidity, and higher mortality rates for surgical patients. The impact on trauma patients is unknown, however. OBJECTIVE: To assess the effect of CDAI on trauma patients and develop a scoring system to predict CDAI in that population. METHODS: Records of all trauma patients admitted to a Level I Trauma Center from 2001 to 2014 were retrospectively reviewed. Presence of CDAI was defined as evidence of positive toxin ...
Source: The Permanente journal - September 13, 2018 Category: General Medicine Tags: Perm J Source Type: research

Sensory Inattention.
Authors: Bakshi N PMID: 30201089 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - September 13, 2018 Category: General Medicine Tags: Perm J Source Type: research

"A" for Life.
"A" for Life. Perm J. 2018 Aug 30;22: Authors: Ahmed F, Ali SA Abstract This is a story of a medical intern whose cascade of baffling thoughts about pursuing a career finally led to a gratifying conclusion. This young intern is easily swayed by the opinions of others, but circumstances proved that the field he chose was the one he was made for. This is a story of determination and belief in one's ability, which gave the power to fight against the odds. PMID: 30201090 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - September 13, 2018 Category: General Medicine Tags: Perm J Source Type: research

Therapeutic Interferon Interchange in Relapsing Multiple Sclerosis Lowers Health Care and Pharmacy Expenditures with Comparable Safety.
Authors: Hahn N, Palmer KE, Klocke S, Delate T Abstract INTRODUCTION: For patients with a less-active (fewer relapses or complete recovery from relapses, less radiologic burden of disease, or no or limited disease-related disability) relapsing form of multiple sclerosis (MS), interferon (IFN) beta-1b subcutaneous is similar in efficacy to IFN beta-1a intramuscular and subcutaneous. The purpose of this study was to assess the impact of patient interchange from an IFN beta-1a to IFN beta-1b. METHODS: This was a retrospective, pre-post study of adult patients with relapsing MS who underwent interchange from an IFN...
Source: The Permanente journal - September 13, 2018 Category: General Medicine Tags: Perm J Source Type: research

Listening Beyond Auscultating: A Quality Initiative to Improve Communication Scores in the Hospital Consumer Assessment of Health Care Practitioners and Systems Survey.
CONCLUSION: Medical students used established improvement methods to promote patient-centered care and align patient and physician agendas, providing a strategy to improve hospitalized patients' perceptions of physician listening. PMID: 30028667 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 23, 2018 Category: General Medicine Tags: Perm J Source Type: research

Turbo Metabolism: 8 Weeks to a New You.
Authors: Elder CR PMID: 30028668 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 23, 2018 Category: General Medicine Tags: Perm J Source Type: research

Ode to a Dead Hawk.
Authors: Sigafoes R, Infurnari J PMID: 30028669 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 23, 2018 Category: General Medicine Tags: Perm J Source Type: research

Leg Warmers.
Authors: Greenblatt N, Kunkle T PMID: 30028670 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 23, 2018 Category: General Medicine Tags: Perm J Source Type: research

Efficacy of Bilateral Transcutaneous Posterior Tibial Nerve Stimulation for Fecal Incontinence.
Authors: Dedemadi G, Takano S Abstract CONTEXT: Posterior tibial nerve stimulation is a new second-line treatment for refractory fecal incontinence. OBJECTIVE: To assess the efficacy of bilateral transcutaneous posterior tibial nerve stimulation (BTPTNS) for treatment of fecal incontinence in Japanese patients and its impact on quality of life. DESIGN: A prospective observational-interventional study was conducted from May 2015 to June 2017 in patients with fecal incontinence in whom conservative treatment had failed. All patients received a 30-minute session of stimulation twice weekly for 6 consecutive we...
Source: The Permanente journal - July 23, 2018 Category: General Medicine Tags: Perm J Source Type: research

Lifestyle Medicine in Inflammatory Bowel Disease.
Authors: Chiba M, Nakane K, Komatsu M PMID: 30028672 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 23, 2018 Category: General Medicine Tags: Perm J Source Type: research

Comparative Effectiveness of Surgical Options for Patients with Ductal Carcinoma In Situ: An Instrumental Variable Approach.
CONCLUSION: No significant benefit was observed with a more aggressive surgical procedure in preventing DCIS recurrence or cancer progression in a diverse population. Many patients with DCIS could benefit from BCS with preservation of their body image. Breast conservation followed-up with cancer surveillance is a rational approach to ensure affordable, effective care for patients with DCIS. PMID: 30028673 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 23, 2018 Category: General Medicine Tags: Perm J Source Type: research

Rats! Hantavirus: A Case Report of a Suspected Case in Eastern Tennessee.
DISCUSSION: Efforts are needed to improve clinical recognition and rapid detection of hantavirus infections, to reduce associated mortality. In a patient presenting with gastrointestinal prodromal symptoms followed by cardiopulmonary findings, physicians should pay special attention to that patient's living conditions and maintain a high index of suspicion for hantavirus infection. Early diagnosis is critical to prevent rapid deterioration to hantavirus pulmonary syndrome in some patients. PMID: 30010530 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 18, 2018 Category: General Medicine Tags: Perm J Source Type: research

Implementing a Protocol to Optimize Detection of Chromosome Abnormalities in Cases of Miscarriage or Stillbirth at a Midwestern Teaching Hospital.
CONCLUSION: A protocol of reflexing to CMA or proceeding directly with CMA gives a higher diagnostic yield in the genetic evaluation of SAB or IUFD. Institutions should consider implementing a genetic testing protocol to improve diagnostic yield. Our study results emphasize the importance of proceeding directly to microarray analysis and give support for current clinical recommendations for genetic testing after fetal demise. PMID: 30010531 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 18, 2018 Category: General Medicine Tags: Perm J Source Type: research

Marijuana's Influence on Pain Scores, Initial Weight Loss, and Other Bariatric Surgical Outcomes.
CONCLUSION: Perioperative opioid use was significantly higher in the MJ-user group despite lower subjective pain scores. The difference in opioid requirements suggests an interaction between MJ use and opioid tolerance or pain threshold. The percentage of total body weight loss, improvement in medical comorbidity, and incidence of postoperative complications at 90-day follow-up were not affected by MJ use in this cohort analysis. PMID: 30010532 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 18, 2018 Category: General Medicine Tags: Perm J Source Type: research

Tracks.
Authors: Morrison W, Ennis T PMID: 30010533 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 18, 2018 Category: General Medicine Tags: Perm J Source Type: research

Continuity of Care in Residency Teaching Practices: Lessons from "Bright Spots".
This article highlights strategies to optimize continuity of care pioneered by 3 "bright spot" residency teaching clinics with high-continuity performance. The strategies include adopting a strong continuity culture and patient scheduling algorithms that prioritize continuity, appointing a team continuity anchor, and/or reorganizing resident and faculty schedules to maximize continuity. We hope that these perspectives can assist residency teaching practices to improve continuity of care for their patients. PMID: 30010534 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 18, 2018 Category: General Medicine Tags: Perm J Source Type: research

Palliative Surgery for Metastatic Fungating Phyllodes Tumors: A Series of Two Cases.
DISCUSSION: Though both patients finally succumbed to progressive metastatic disease, palliative resection allowed them to have good social and family support to the end. Palliative surgery plays an important role in alleviating suffering of patients with metastatic fungating cystosarcoma phyllodes and has the potential to improve their quality of life significantly. PMID: 30010535 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 18, 2018 Category: General Medicine Tags: Perm J Source Type: research

Understanding Waste in Health Care: Perceptions of Frontline Physicians Regarding Time Use and Appropriateness of Care They and Others Provide.
CONCLUSION: On the basis of these findings, it is apparent that within at least one health care system, the opportunity to increase value through task shifting and avoiding inappropriate care is more narrow than commonly perceived on a national level. PMID: 30010536 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 18, 2018 Category: General Medicine Tags: Perm J Source Type: research

Balloons of Hope.
Authors: Obeidat AZ, Al-Khun N Abstract A neurology fellow describes an emotionally draining workday beginning with a long commute delayed by a scene of accidental death. During patient rounds, the day continued with misery as this physician watched and declared brain death in two patients. Opioids took away the life of a young, loving father from his growing family. Opioids robbed an unborn child from seeing her mother. Opioids made this physician feel helpless and caused him to think, Why is this happening? How to stop it? And when does it end? This narrative essay illustrates, with words and art, the need to sta...
Source: The Permanente journal - July 18, 2018 Category: General Medicine Tags: Perm J Source Type: research

An Observational Study of Cardiovascular Risks Associated with Rheumatoid Arthritis Therapies: A Comparison of Two Analytical Approaches.
CONCLUSION: In comparative safety studies, we recommend greater transparency in classifying treatment and evaluating disenrollment. PMID: 30010538 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 18, 2018 Category: General Medicine Tags: Perm J Source Type: research

Invasive Basal Cell Carcinoma of the Skin Treated Successfully with Vismodegib: A Case Report.
DISCUSSION: Although BCC is the most common skin cancer, it is usually a local disease and treated with local measures. Metastatic BCC is extremely rare, and in cases when surgical resection or local radiation are not viable options, chemotherapeutic agents typically offer very limited improvement. Vismodegib is an oral selective sonic hedgehog pathway inhibitor that shows benefit in patients with locally advanced or metastatic disease. PMID: 30005721 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 16, 2018 Category: General Medicine Tags: Perm J Source Type: research

The Unmet Challenge of Medication Nonadherence.
Authors: Kleinsinger F Abstract Medication nonadherence for patients with chronic diseases is extremely common, affecting as many as 40% to 50% of patients who are prescribed medications for management of chronic conditions such as diabetes or hypertension. This nonadherence to prescribed treatment is thought to cause at least 100,000 preventable deaths and $100 billion in preventable medical costs per year. Despite this, the medical profession largely ignores medication nonadherence or sees it as a patient problem and not a physician or health system problem. Much of the literature on nonadherence focuses on barri...
Source: The Permanente journal - July 16, 2018 Category: General Medicine Tags: Perm J Source Type: research

Impact of Body Mass Index on Postconcussion Symptoms in Teenagers Aged 13 to 18 Years.
CONCLUSION: After concussion, irritability and impulsivity may be more likely than headaches in overweight and obese patients. There was no difference in recovery time between obese and healthy-weight teens. These findings may have importance in the evaluation, treatment, and anticipatory guidance of patients with concussions. PMID: 30005723 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 16, 2018 Category: General Medicine Tags: Perm J Source Type: research

Pigments and Medicine.
Authors: Beekley S PMID: 30005724 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 16, 2018 Category: General Medicine Tags: Perm J Source Type: research

Pyeloduodenal Fistula in Xanthogranulomatous Pyelonephritis: A Series of Two Cases.
We present two cases with recurrent kidney infections who each ultimately received a nephrectomy and repair of their duodenal fistula. PMID: 30005725 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 16, 2018 Category: General Medicine Tags: Perm J Source Type: research

Relapse Prevention in Ulcerative Colitis by Plant-Based Diet Through Educational Hospitalization: A Single-Group Trial.
CONCLUSION: Relapse rates after educational hospitalization providing a PBD were far lower than those reported with medication. Educational hospitalization is effective at inducing habitual dietary changes. PMID: 30005726 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 16, 2018 Category: General Medicine Tags: Perm J Source Type: research

Image Diagnosis: Plummer-Vinson Syndrome: An Unusual Cause of Dysphagia.
Authors: Chhabra P, Khurana H PMID: 30005727 [PubMed - in process] (Source: The Permanente journal)
Source: The Permanente journal - July 16, 2018 Category: General Medicine Tags: Perm J Source Type: research